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      Comparison of Conventional Statistical Methods with Machine Learning in Medicine: Diagnosis, Drug Development, and Treatment

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          Abstract

          Futurists have anticipated that novel autonomous technologies, embedded with machine learning (ML), will substantially influence healthcare. ML is focused on making predictions as accurate as possible, while traditional statistical models are aimed at inferring relationships between variables. The benefits of ML comprise flexibility and scalability compared with conventional statistical approaches, which makes it deployable for several tasks, such as diagnosis and classification, and survival predictions. However, much of ML-based analysis remains scattered, lacking a cohesive structure. There is a need to evaluate and compare the performance of well-developed conventional statistical methods and ML on patient outcomes, such as survival, response to treatment, and patient-reported outcomes (PROs). In this article, we compare the usefulness and limitations of traditional statistical methods and ML, when applied to the medical field. Traditional statistical methods seem to be more useful when the number of cases largely exceeds the number of variables under study and a priori knowledge on the topic under study is substantial such as in public health. ML could be more suited in highly innovative fields with a huge bulk of data, such as omics, radiodiagnostics, drug development, and personalized treatment. Integration of the two approaches should be preferred over a unidirectional choice of either approach.

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          Most cited references44

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          Deep learning.

          Deep learning allows computational models that are composed of multiple processing layers to learn representations of data with multiple levels of abstraction. These methods have dramatically improved the state-of-the-art in speech recognition, visual object recognition, object detection and many other domains such as drug discovery and genomics. Deep learning discovers intricate structure in large data sets by using the backpropagation algorithm to indicate how a machine should change its internal parameters that are used to compute the representation in each layer from the representation in the previous layer. Deep convolutional nets have brought about breakthroughs in processing images, video, speech and audio, whereas recurrent nets have shone light on sequential data such as text and speech.
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            Dermatologist-level classification of skin cancer with deep neural networks

            Skin cancer, the most common human malignancy, is primarily diagnosed visually, beginning with an initial clinical screening and followed potentially by dermoscopic analysis, a biopsy and histopathological examination. Automated classification of skin lesions using images is a challenging task owing to the fine-grained variability in the appearance of skin lesions. Deep convolutional neural networks (CNNs) show potential for general and highly variable tasks across many fine-grained object categories. Here we demonstrate classification of skin lesions using a single CNN, trained end-to-end from images directly, using only pixels and disease labels as inputs. We train a CNN using a dataset of 129,450 clinical images—two orders of magnitude larger than previous datasets—consisting of 2,032 different diseases. We test its performance against 21 board-certified dermatologists on biopsy-proven clinical images with two critical binary classification use cases: keratinocyte carcinomas versus benign seborrheic keratoses; and malignant melanomas versus benign nevi. The first case represents the identification of the most common cancers, the second represents the identification of the deadliest skin cancer. The CNN achieves performance on par with all tested experts across both tasks, demonstrating an artificial intelligence capable of classifying skin cancer with a level of competence comparable to dermatologists. Outfitted with deep neural networks, mobile devices can potentially extend the reach of dermatologists outside of the clinic. It is projected that 6.3 billion smartphone subscriptions will exist by the year 2021 (ref. 13) and can therefore potentially provide low-cost universal access to vital diagnostic care.
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              Development and Validation of a Deep Learning Algorithm for Detection of Diabetic Retinopathy in Retinal Fundus Photographs.

              Deep learning is a family of computational methods that allow an algorithm to program itself by learning from a large set of examples that demonstrate the desired behavior, removing the need to specify rules explicitly. Application of these methods to medical imaging requires further assessment and validation.
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                Author and article information

                Journal
                Medicina (Kaunas)
                medicina
                Medicina
                MDPI
                1010-660X
                1648-9144
                08 September 2020
                September 2020
                : 56
                : 9
                : 455
                Affiliations
                [1 ]Neonatal Intensive Care Unit, Department of Surgical Sciences, AOU and University of Cagliari, 09042 Cagliari, Italy; hemasekhar09@ 123456gmail.com (H.S.R.R.); vafanos@ 123456tin.it (V.F.)
                [2 ]Marie Sklodowska-Curie CAPICE Project, Department of Surgical Sciences, University of Cagliari, 09042 Cagliari, Italy
                [3 ]Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37129 Verona, Italy; giuseppe.verlato@ 123456univr.it (G.V.); nadia.antonucci@ 123456univr.it (N.A.)
                [4 ]Section of Psychiatry, Department of Medical Science and Public Health, University of Cagliari, 09125 Cagliari, Italy
                [5 ]Department of Pharmacology, Dalhousie University, Halifax 6299, NS B3H 4R2, Canada
                Author notes
                [* ]Correspondence: mirkomanchia@ 123456unica.it
                Author information
                https://orcid.org/0000-0001-5262-8818
                https://orcid.org/0000-0003-4175-6413
                https://orcid.org/0000-0001-6099-6207
                Article
                medicina-56-00455
                10.3390/medicina56090455
                7560135
                32911665
                bab6d524-e688-4ba0-a366-a183b19822be
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 15 July 2020
                : 07 September 2020
                Categories
                Review

                machine learning,medicine,healthcare,diagnosis,drug development,personalized treatment,autonomous technology

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